Bacterial infections in lupus: Roles in promoting immune activation and in pathogenesis of the disease.
Bacterial infections in lupus: Roles in promoting immune activation and in pathogenesis of the disease.
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DOI：
10.1016/j.jtauto.2020.100078
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发表时间：
2021
影响因子：
3.9
通讯作者：
Garrett-Sinha LA
中科院分区：
文献类型：
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作者：
Battaglia M;Garrett-Sinha LA
肺部、皮肤、血流和其他组织的细菌感染在系统性红斑狼疮（狼疮）患者中很常见，并且通常比对照人群中的类似感染更严重和更具侵袭性。各种研究已经探索了狼疮患者中细菌丰度的变化，感染率以及特定细菌物种对疾病进展的影响，使用人类患者样本和狼疮小鼠模型。本综述的目的是总结人类和小鼠的研究，这些研究描述了狼疮中细菌微生物组的变化，漏肠在刺激炎症中的作用，与狼疮相关的特定细菌物种的鉴定，以及某些常见细菌感染在促进狼疮进展中的潜在作用。使用Pubmed数据库搜索与狼疮细菌感染以及与狼疮相关的微生物组变化相关的文章来收集信息。回顾的研究表明，与对照受试者相比，狼疮患者的细菌微生物组发生了显着变化，与对照小鼠相比，狼疮易感小鼠也发生了显着变化。此外，有证据支持狼疮患者和狼疮易感小鼠存在肠道渗漏。这种泄漏的肠道可能允许活细菌或细菌成分进入循环并引起炎症。侵袭性细菌感染在狼疮患者中更常见，而且往往更严重。这些包括由金黄色葡萄球菌、肠道沙门氏菌、大肠杆菌、肺炎链球菌和分枝杆菌引起的感染。这些细菌感染可引发增加的免疫激活和炎症，潜在地刺激自身反应性淋巴细胞的激活并导致狼疮症状恶化。总之，证据表明狼疮易感染，而感染可能引发狼疮恶化，导致反馈循环，可能会加强自身免疫性症状。严重的细菌感染在狼疮患者中很常见，并导致发病率和死亡率。漏肠综合征在许多狼疮患者和狼疮小鼠模型中发现。狼疮中的细菌微生物组发生了变化。特定的细菌感染可以刺激小鼠模型中狼疮症状的发展。在细菌感染和自身免疫之间可能存在反馈回路，使得它们相互放大。
Bacterial infections of the lung, skin, bloodstream and other tissues are common in patients with systemic lupus erythematosus (lupus) and are often more severe and invasive than similar infections in control populations. A variety of studies have explored the changes in bacterial abundance in lupus patients, the rates of infection and the influence of particular bacterial species on disease progression, using both human patient samples and mouse models of lupus. The aim of this review is to summarize human and mouse studies that describe changes in the bacterial microbiome in lupus, the role of a leaky gut in stimulating inflammation, identification of specific bacterial species associated with lupus, and the potential roles of certain common bacterial infections in promoting lupus progression. Information was collected using searches of the Pubmed database for articles relevant to bacterial infections in lupus and to microbiome changes associated with lupus. The reviewed studies demonstrate significant changes in the bacterial microbiome of lupus patients as compared to control subjects and in lupus-prone mice compared to control mice. Furthermore, there is evidence supporting the existence of a leaky gut in lupus patients and in lupus-prone mice. This leaky gut may allow live bacteria or bacterial components to enter the circulation and cause inflammation. Invasive bacterial infections are more common and often more severe in lupus patients. These include infections caused by Staphylococcus aureus, Salmonella enterica, Escherichia coli, Streptococcus pneumoniae and mycobacteria. These bacterial infections can trigger increased immune activation and inflammation, potentially stimulating activation of autoreactive lymphocytes and leading to worsening of lupus symptoms. Together, the evidence suggests that lupus predisposes to infection, while infection may trigger worsening lupus, leading to a feedback loop that may reinforce autoimmune symptoms. Severe bacterial infections are common in lupus patients and lead to morbidity and mortality. A leaky gut syndrome is found in many lupus patients and mouse models of lupus. There are changes to the bacterial microbiome in lupus. Specific bacterial infections can stimulate development of lupus symptoms in mouse models. There may be feedback loops between bacterial infection and autoimmunity such that they mutually amplify each other.